If There's No Family History of Allergies
Cereal is usually recommended as a baby's first food. Rice cereal is well tolerated because it lacks gluten and isn't very likely to cause an allergic reaction. Oatmeal and barley are other popular options that follow soon after solids are started between 4 and 6 months.
An interesting finding regards a somewhat increased risk of wheat allergy if grains are introduced after 6 months. The study, published in Pediatrics concluded, "Delaying exposure until after 6 months was associated with an increase risk of wheat allergy, not a protective effect. In addition, these findings confirm the role of family history of allergy as a predictor of food allergy outcomes in children. Our results support continuing the current recommendations of first introducing cereal products between 4 and 6 months of age." So, give rice and oatmeal a try between 4 and 6 months and add mixed cereals containing wheat after those are well tolerated.
If You Have Allergies in the Family
If you have food allergies in your family, it's best to avoid wheat until your child is at least 1 year of age, possibly older. Consult your health care provider to be sure. But again, don't delay the introduction of grains altogether, as the study mentioned above was related to wheat allergy but was not specifically related to introducing only wheat between 4 and 6 months. The grains introduced could have been wheat, barley, rye or oats. Of those, the safest to introduce to a child with a family history of allergies would be oats at 6 months, which is when health care providers recommend children with a history of allergies start solids.Some items to be aware of that contain wheat include most cereals labeled "Mixed Grains." Gerber's Mixed Grains list wheat flour as the first ingredient, for example. Also be aware that teething biscuits and zwieback toasts often contain wheat and pasta is often made from wheat. The FDA requires that food labels state when foods contain wheat, so read those carefully.
Whether or not you have a history of allergies, the first time you introduce wheat, be sure to watch for the signs of an allergic reaction (hives, difficulty breathing or asthma symptoms, swelling of the mouth or throat, vomiting or diarrhea and loss of consciousness), know how to respond and be ready to call 9-1-1 immediately.
It May Not Be Wheat Allergy, but Gluten Intolerance or Celiac Disease
Celiac disease is a condition where eating foods containing gluten causes the immune system to react and attack the stomach lining, sometimes causing permanent damage. Celiac disease can appear in infancy and may appear as early as the first time a child is fed a food containing gluten. According to Nancy Lapid, "In the classic form of celiac disease, patients have severe chronic diarrhea with voluminous stools that float in the water, and weight loss to the point of wasting. This form is very common in infants and young children with celiac disease, who tend to develop bowel symptoms and growth problems shortly after they begin to eat gluten-containing cereals. In fact, it was once thought (incorrectly) that celiac disease occurred only in children, and that in most cases the children could outgrow it."
In addition, some evidence is emerging that suggests the early (before 4 months) introduction of foods containing gluten may actually increase the risk of celiac disease. Mothers who are currently breastfeeding can possibly minimize the risk by introducing wheat or barley cereal no earlier than 4 months and no later than 6 months. This is especially true for children who are already at risk of developing celiac disease. If you see symptoms like diarrhea, poor appetite, slow growth and chronic stomach pain, talk to your health care provider and stop giving your child foods containing wheat, barley and rye. Fall back on rice, which is gluten-free, and oatmeal, which is generally considered safe, though there may be cross-contamination issues in facilities that also produce foods with wheat.
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